Individual provider · NPI-1

Dr. Regina Lorren Holloway, MD

Family Medicine · Bremen, GA

NPI number1063584324
StatusActive
Last updated in NPPESJul 14, 2010

Details

NPI
1063584324
Entity type
Individual (NPI-1)
Name
Dr. Regina Lorren Holloway
Credential
MD
Sex
Female
Sole proprietor
Yes
Enumeration date
Nov 14, 2006
Last updated
Jul 14, 2010

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine034852GAYes
207K00000X Allergy & Immunology034852GA

Practice location

308 Carrollton Street
Bremen, GA 30110

Phone 770-537-1960 · Fax 770-537-1901

Mailing address

308 Carrollton Street
Bremen, GA 30110

Phone 770-537-1960 · Fax 770-537-1901

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